| NPI | 1073170908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.018519) |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2023-03-27 |